From CNN.com Today/Eissenberg study with feedback

[quovadis]

Aha ....does not deliver!
They were probably running the study on a 510 with no battery and a dead atty..
I think we should send that Eisenhower (or whatever his name is) fellow, a few chucks
At 6 volts with a heavy cigar shag....
Then he can comment on whether it delivers or not!!!!!!!!

 

[Vocalek]

Description of the study is here: Evaluating the Acute Effects of Electronic Nicotine Delivery Devices Marketed to Smokers. - Full Text View - ClinicalTrials.gov

They used prefilled cartridges from Crown 7 and njoy. I pointed out that many users have found it necessary to do primer puffs on njoy (I'm unfamiliar with the other product) to get the vapor going.

From the study description, it sounded as if there was an expectation that 10 puffs from a regular cigarette should equal 10 puffs from an electronic cigarette. Dr. E's response here has corrected that impression. But the fact remains that all puffs are not equal. A lot depends on your equipment, what's in your cartridge, and your inhaling technique.

Given all the variables, I am not sure that it's possible to generalize on how much nicotine is delivered by an electronic cigarette on a "per puff" basis.

 

[Sun Vaporer]

If you want details on the study design, google "NCT00932295" and click on the first hit. I cannot post links or I would do it myself. It is no secret: the design has been presented and discussed on these forums in the past....

Yes--I remember when this study was first seeking people. You could NOT participate if you where already using the e-cig--never could figure out why that was an issue? Sun

"Exclusion criteria include: history of chronic health problems or psychiatric conditions, breastfeeding, or pregnancy (assessed by urinalysis). Individuals who report current attempts to quit smoking, previous experience with Crown Seven or njoy. Individuals who report alcohol or marijuana use greater than 20 days within the last 30 days, or recent illicit drug use such as ....... or ....... Women reporting active menopause will be excluded (menopause may cause tobacco/nicotine withdrawal-like symptoms, such as depression, Parry et al., 2001).


http://clinicaltrials.gov/ct2/show/NCT00932295

 

[slybootz]

If you want details on the study design, google "NCT00932295" and click on the first hit. I cannot post links or I would do it myself. It is no secret: the design has been presented and discussed on these forums in the past....

thank you!

slybootz, we'll see about those things when the study is published. I'd virtually guarantee it's stock equipment from vendors who are better known to the public. Cart strength, I believe, was 16mg. A number of variables can affect nicotine delivery though, besides these. Length of puff, user acquaintance with the product, time between puffs for effective wicking of fluid, etc. etc. It'll be an interesting read when it comes out, especially if the nic levels are quantified in detail...I'd like to compare both methodology and nicotine concentration in the vapor with other analyses.

no wonder they didn't deliver...They were NJOY as well as a Crown7 brand PVs that were used in the study

 

[quovadis]

I think we should all believe Eisenhower and start smoking analogs again.

 

[teissenb]

A new cartridge (within its expiration date) and a fully charged battery were used for each session.

Completely agree that all puffs are not the same. Completely agree that other methods will also be useful. One study rarely answers every question. Here is an excerpt from the study conclusions:

"Importantly,
these results were from two specific products
tested under acute conditions in which puff
number was controlled. Variability in product
design may influence vapour content and
chronic use and/or more intensive puffing (ie,
more puffs, greater puff volume) may influence
nicotine delivery."

My point? The study conclusions are appropriately qualified. You can bet I would like to conduct more well-controlled studies addressing the very points raised here. The study was designed, in part, to answer a very specific question, and it serves that purpose. Other questions require other studies.

 

[Sun Vaporer]

teissenb--Appreciate the Study, but there are very few people on here that use NJOY or Crown 7 let alone those dried up pre-filled cartridges. Most on the Forum use E-liquid. No wonder this study showed that the nicotine was a little lacking.


Sun

 

[TropicalBob]

Yet another researcher/doctor appears on this forum and gets stoned by rabid vapers. In the two years I've been here, ECF wild-eyed posters have driven off several good men who might have taught us something of value.

The forum has become as uncivil as Congress. Please, read his posts and give him the benefit of doubt that his research was done without bias in favor of Big Tobacco and against e-cigs. Given the variables of his testing, he got his results.

Read them, and if your situation is different, bravo for you.

But his results are likely dead-on accurate, for a variety of reasons the study will detail when the PDF is released.

 

[DVap]

Dr. Eissenberg, I appreciate your stopping by.

Last year I did a rough study (analytical chemist of 2+ decades here) via cryogenic trapping and titrimetric determination that suggested about half the nicotine in the liquid gets delivered to the vapor. Another forum member here with a laboratory background picked up where I left off and devised a much more robust testing methodology that suggested that most all of the nicotine in liquid gets delivered to the vapor.

Amid the typical forum noise and discussion, there's some pretty solid stuff here.

Of course, demonstrating that nicotine is delivered at a high percentage to the vapor does not prove that the nicotine in the vapor makes it to the body. This we know simply because some of us have managed to "vape ourselves ill" and we could/can do so reproducibly (but that's not something one should really make an attempt to do).

Questions arise about the testing for nicotine... Those of us here who study this believe that cigarettes deliver a much sharper/higher peak plasma level of nicotine than e-cigarettes. Were cotinine levels (nicotine metabolute with a much longer half-life) tested after perhaps 8 hours (several nicotine half-lives), to get a picture of the total nicotine absorption rather than just the peak?

I'm not saying your research is "wrong", just offering my perspective and criticism (criticism in the technical sense). I just wonder if the experimental design takes into account such things as puff for puff equivalency (does a puff on a 16 mg ecig equate to a puff on a full flavor analog?) , absorption profile of tobacco (rapid peak via lung absorption) vs ecig (slower absorption in the throat/mouth), and overall dose (testable more readily via monitoring of a much longer half-life metabolite than nicotine itself).

 

[CaptJay]

Great to see Dr E replying
Appreciate the response Doc - also appreciate you are reporting on data, rather than garnering opinions (which is of course not scientific) but next time, perhaps ask/poll actual PV users which ecigs are actually being USED by them. The ones tested are not used widely for a reason, they don't work well (perhaps for the very reasons your study has exposed).

I wouldn't be upset with a 'sham smoking' theory (if it works, it works, right?) if I hadn't experienced different physical reactions to different strength liquids (12mg seems fine no cravings, 18mg ditto, 24mg gives me jitters headaches and I feel anxious and irritable).
Placebo wouldn't give those reactions, which is almost shame - a placebo that actually works really well would be fine with me.

 

[Sun Vaporer]

Dr. Eissenberg, I appreciate your stopping by.

Last year I did a rough study (analytical chemist of 2+ decades here) via cryogenic trapping and titrimetric determination that suggested about half the nicotine in the liquid gets delivered to the vapor. Another forum member here with a laboratory background picked up where I left off and devised a much more robust testing methodology that suggested that most all of the nicotine in liquid gets delivered to the vapor.

Amid the typical forum noise and discussion, there's some pretty solid stuff here.

Of course, demonstrating that nicotine is delivered at a high percentage to the vapor does not prove that the nicotine in the vapor makes it to the body. This we know simply because some of us have managed to "vape ourselves ill" and we could/can do so reproducibly (but that's not something one should really make an attempt to do).

Questions arise about the testing for nicotine... Those of us here who study this believe that cigarettes deliver a much sharper/higher peak plasma level of nicotine than e-cigarettes. Were cotinine levels (nicotine metabolute with a much longer half-life) tested after perhaps 8 hours (several nicotine half-lives), to get a picture of the total nicotine absorption rather than just the peak?

I'm not saying your research is "wrong", just offering my perspective and criticism (criticism in the technical sense). I just wonder if the experimental design takes into account such things as puff for puff equivalency (does a puff on a 16 mg ecig equate to a puff on a full flavor analog?) , absorption profile of tobacco (rapid peak via lung absorption) vs ecig (slower absorption in the throat/mouth), and overall dose (testable more readily via monitoring of a much longer half-life metabolite than nicotine itself).

Exactly DVap--There is nothing wrong with discussing or pointing out concerns in any Study.

Just like the FDA's Study, we should not bow down because it is a Study and not dare to have questions about it. As was pointed out, the Study was limited to NJOY and Crown 7, and in that aspect really not represenative of the e-cig as we know it here.

In any case the efforts of any Study are appreciated, and any valid Study should welcome input, discussion, and thoughts.


Sun

 

[dk2]

This is Dr. Tom Eissenberg.

I have no conflicts of interest associated with e-cigarettes. The e-cigarette study was funded by the National Cancer Institute. My work has *never* been funded by the tobacco industry: anybody who says differently is not telling the truth and should be asked to provide evidence. My pharmaceutical industry funded research has *never* involved either nicotine or tobacco and, in any case, the last such study I conducted was back in ~2001 or ~2002. VCU (the university where I worked) had an unfortunate contract with Philip Morris a few years ago that has since been terminated; I knew nothing about it, was never part of it, and protested it when I learned of it. I repeat: I have no conflicts of interest associated with this study.

As for the CNN report, CNN released their story before the study was ready for release by Tobacco Control. I was as surprised as you to see the story this morning -- CNN had agreed to wait for publication. I am trying very hard to get a final PDF copy of the study from Tobacco Control so that I can share it. Right now all I have is uncorrected galley proofs.

Finally, you should understand that one of the purposes of the study was to determine how much nicotine the products I was testing delivered to naive users under acute dosing conditions. Of course their are other studies that can be conducted and I can assure you I noted the study's limitations (these products, these cartridges, these conditions) in the discussion. Frankly, I was interested in the nicotine delivery, whatever it was, and had no preconceived notions or agenda. Indeed, that is why the two control conditions (own brand cigarettes, sham smoking) are included -- I wanted the two extremes (efficient nicotine delivery, no nicotine delivery) to see where the e-cigs ended up: more like a normal cigarette or more like sham smoking. I am sorry if the results are not agreeable to some of you: I don't control the data, I report them.

Finally, I saw another thread on here where people describe vaping and using snus at the same time, and someone else on this thread noted (as have others elsewhere) that they vape more frequently than they used to smoke. One person reported smoking normal tobacco cigarettes when stressed, but vaping at other times. All of these observations are all consistent with a product (e cig) that may not be delivering the nicotine dose to which the user has become accustomed.

Thanks for your attention. When the PDF is available, you'll hear about it.

Tom E.

I appreciate your response on this form to our criticism of your test results, however your response varies greatly from the CNN article in question, in which you are quoted as saying, "They are as effective at nicotine delivery as puffing on an unlit cigarette" Are these not your words and do you not feel that this is misleading to the public in the context of the article?

 

[Our House]

Thanks for stopping in to post. We appreciate it.

A couple of things:

Finally, I saw another thread on here where people describe vaping and using snus at the same time, and someone else on this thread noted (as have others elsewhere) that they vape more frequently than they used to smoke. One person reported smoking normal tobacco cigarettes when stressed, but vaping at other times. All of these observations are all consistent with a product (e cig) that may not be delivering the nicotine dose to which the user has become accustomed.

All of those observations are also the exception, not the rule. Most users on this forum (from what I've seen and as long as I've been here), as well as most users I know in real life, only vape now. And most of them vape right around as much as they used to smoke. I personally use my ecig less than my old 2pk/day habit.

Also, how did you get your hands on a 16mg NJOY cartridge for the study? NJOY cartridges only come in 0mg, 6mg, 12mg and 18mg.

 

[BigJimW]

Exactly DVap--There is nothing wrong with discussing or pointing out concerns in any Study.

Just like the FDA's Study, we should not bow down because it is a Study and not dare to have questions about it. As was pointed out, the Study was limited to NJOY and Crown 7, and in that aspect really not represenative of the e-cig as we know it here.

In any case the efforts of any Study are appreciated, and any valid Study should welcome input, discussion, and thoughts.


Sun

Sun, question.

I may get my .... flamed here, but there is a flaw. Not that I mind questioning these type of research projects, but there is a big flaw. It is the "see no evil" route.

Case in point. Several months ago I posted a video regarding a chocking hazard to certain carts. I got systematically flamed by some in the community for actually having the balls to post this video. Some even accused me of staging it.

TropicalBob made a video and in one of the parts of the video, he was addressing the same issue. This revolves around the 501 carts and the end caps that pop off under very little pressure, creating a choking hazard.

So, here is the problem. It is becoming more and more apparent that no matter what is tossed out, it will be dismissed by the community as junk science. Even if NASA came out with a study, it would be considered trash science.

Yes, I know the FDA "study" is BS, but what will the community do if a REAL study comes out that may actually point a real danger to vaping? Not likely will that happen, but how can the community keep an open mind with potential issues? If we can't conduct ourselves proper when a simple contributor issues a warning, how the hell will be conduct ourselves if something real comes down the pike?

I think the community still needs to question studies, but also with the understanding that maybe some of these studies may actually be correct. Taking a paranoid "world is out to get us" route is not the answer.

Just my thoughts.

 

[DVap]

One thing to note is that the study did focus on "naive ecig users" with no previous experience. This naivety would make the selection of an ecig such as an NJoy or a Crown 7 much more likely. They wouldn't know any better.

I have serious concerns about Dr. E. using a naive population for the study, and then drawing overarching conclusions about ecig nicotine delivery via this naive population. Imagine non-smokers (naive) being told to take 10 puffs off a Marlboro Red and then conclusions about cigarette nicotine delivery being drawn based on this population (who would probably be too busy coughing to get a good lungful).

In short, this population was given ecigs models that a great majority of the members of this forum would never use or perhaps admit sheepishly, "Yea, I used that when I started, but I know better now". (although in fairness, I did manage to get pretty good vapor from an NJoy with a 4801 atty once I got the bugs ironed out), and they didn't particularly know how to use them.

I'm tempted here to start rehashing various experimentation I've done on microliters of eliquid vaporized per second by a good ecig (it's about 1 uL/sec btw, 5-place balances are nice!) to speculate on how much actual eliquid was vaporized by this naive population using what this forum would consider non-ideal equipment... but that would probably be tedious, so I won't. The point I'm here to make with this post is simply that the design of the test seems to bias the results to the low side via 1) inexperienced subjects, and 2) arguably non-ideal equipment, and 3) not taking advantage of measuring a much longer lived metabolite easily tested for (as mentioned in my previous post in this thread).

If the study is meant to show peak plasma nicotine concentrations among naive ecig users (no experience, no frame of reference), then that's fair enough, but to draw overarching conclusions (as I previously described them) about ecigs in general based on this experimental design, in my opinion, invites the sort of criticism I'm currently offering up. (And if Dr. E. is the professional I believe he is, he'll take this criticism as intended, certainly not as ridicule, but as criticism in the sense of the word that a scientist would and should take it).

I return to my analogy of asking non-smokers to take 10 draws off a Red, they're going to be pretty bad at it (cue coughing). Smokers know how to smoke and vapers know how to vape.

Ask me to take 10 puffs of 16 mg off my 2.5 ohm 510 attached to a Chuck at 3.7 volts with an Ultrafire 3000 mAh battery (let's not even mention 6 volts!), well-primed and vaping like a steam locomotive, and with 30 seconds between puffs, I'll heat that sucker up!

Oh, and measure cotinine instead of (or in addition to) nicotine. Had to mention that one more time.

 

[BigJimW]

Yet another researcher/doctor appears on this forum and gets stoned by rabid vapers. In the two years I've been here, ECF wild-eyed posters have driven off several good men who might have taught us something of value.

Agreed. And hence my question in the last post. Turning a blind eye is NOT the answer.

 

[YoMike]

Finally, you should understand that one of the purposes of the study was to determine how much nicotine the products I was testing delivered to naive users under acute dosing conditions.

Why test NAIVE users, is the data really meaningful for anything?
Sort of like testing the new Titleist golf ball for distance with people that never have swung a club in their life. Dr. Eissenberg you've been a member here for 7 months and I'm sure you've done some reading. The only board info you have quoted,

This is Dr. Tom Eissenberg.

Finally, I saw another thread on here where people describe vaping and using snus at the same time, and someone else on this thread noted (as have others elsewhere) that they vape more frequently than they used to smoke. One person reported smoking normal tobacco cigarettes when stressed, but vaping at other times. All of these observations are all consistent with a product (e cig) that may not be delivering the nicotine dose to which the user has become accustomed.

Thanks for your attention. When the PDF is available, you'll hear about it.

Tom E.

Dr. Eissenberg you didn't happen to notice the 82% of the 1500 members who participated in a poll quit regular cigarettes with the help of the ecigs? Research that, find out what these users are getting from ecigs because whatever it is works!
http://www.e-cigarette-forum.com/forum/polls/6470-e-cig-success-rate.html
Dr. Eissenberg are you just looking for talking points to minimize the impact of the ecigarettes, sure looks that way to me.

40 years a smoker it's been 5 months since I've smoked a lit cigarette!
My research concludes the ecigarette works!

 

[DVap]

Sun, question.

I may get my .... flamed here, but there is a flaw. Not that I mind questioning these type of research projects, but there is a big flaw. It is the "see no evil" route.

Case in point. Several months ago I posted a video regarding a chocking hazard to certain carts. I got systematically flamed by some in the community for actually having the balls to post this video. Some even accused me of staging it.

TropicalBob made a video and in one of the parts of the video, he was addressing the same issue. This revolves around the 501 carts and the end caps that pop off under very little pressure, creating a choking hazard.

So, here is the problem. It is becoming more and more apparent that no matter what is tossed out, it will be dismissed by the community as junk science. Even if NASA came out with a study, it would be considered trash science.

Yes, I know the FDA "study" is BS, but what will the community do if a REAL study comes out that may actually point a real danger to vaping? Not likely will that happen, but how can the community keep an open mind with potential issues? If we can't conduct ourselves proper when a simple contributor issues a warning, how the hell will be conduct ourselves if something real comes down the pike?

I think the community still needs to question studies, but also with the understanding that maybe some of these studies may actually be correct. Taking a paranoid "world is out to get us" route is not the answer.

Just my thoughts.

Jim, I believe some forum members will go apoplectic if this were to happen.

Good science stands the light of day (you can poke it with a stick and it doesn't fall apart). Bad science does not (see the bogus/biased FDA study). There are those in this community who can competently critique scientific studies, and there are those outside who can as well.

Vaping may well have hazards we've not foreseen, but then we get into the realm of harm-reduction... a concept wholly rejected by the more rabid anti's.. "quit or die".

The issue that concerns me most, when looking at bad science (FDA study) is that there is precious little outside critique of this particular badly biased, badly flawed study.

 

[DVap]

Why test NAIVE users, is the data really meaningful for anything?
Sort of like testing the new Titleist golf ball for distance with people that never have swung a club in their life.

Mike, brilliant analogy.

CNN: Those damned Titleists only go 50 yards sideways! 8-o

 

[tarheeldan]

I'm with you BigJimW as far as a bias against research that casts PV's in a negative light being close-minded and unproductive. Some future research is likely to not be all roses.

With regard to this instance, specifically, however I think many of us (I did anyway) took issue with the statement that, as nicotine delivery devices, e-cigs don't work (from personal experience and a low probability that we're all under influence solely of the placebo effect).

While the study itself I'm sure properly confines its scope, the news article did not. This I took issue with as well and the blame there lies with the author of the news piece and not Dr. Eissenberg.